Drug-induced pancreatitis (DIP)belongs to gastrointestinal drug-induced diseases.With the wide use of drugs,the number of drugs that may induce DIP is increasing.Since there are not specific clinical indicators for detecting DIP or a complete diagnostic and thera-peutic process for DIP,its diagnosis is often missed.The epidemiology and pathogenesis of DIP,as well as drugs inducing DIP and their classifications,are reviewed.It is stressed that careful collection of medication history of DIP patients and timely discontinuation of suspected pharmacological agents are the key to diagnosis and treatment of this disease,and the patients should be informed of the related drugs that in-duce DIP to prevent its recurrence.

One hundred and twenty-two patients with confirmed cervical intraepithelial neoplasia (CIN), as a result of occasional screening for uterine cervix cancer in our out-patient clinic between July 2006 and August 2007, and 122 control patients with cervicitis who received colposcopy during the same period were enrolled in this study. Our results showed that 72% participants didn't receive uterine cervix cancer screening during the past 2 years; 55% women had premarital sexual behavior. CIN was most commonly seen in 30 to 34 year old women. Occasional screening could identify 75% CIN. In comparison with the control group, the incidence of earlier first sexual behavior, marriage, and delivery, multiple pregnancy, and frequent abortion was significantly increased in the study group (P < 0.05). We suggest that increased access to uterine cervix cancer screening might be more important than technical improvement.

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.

Objective:To study the relationship between alpha seine/threonine-protein kinase (p-Akt)-serine/ threonine-protein kinase (mTOR)-ribosomal protein S6 kinase (p70S6K) signaling pathway and clinicopathological features or chemoresistance of ovarian cancer.Methods:We checked the p-Akt,mTOR and p70S6K protein levels in 18 tissues with chemoresistance or 25 with chemosensitivity of ovarian cancer by immunohistochemistry technique,and analyzed the relationship between those proteins and clinicopathological features or chemoresistance of ovarian cancer.Results:The levels of p-Akt protein in ovarian serous carcinoma,mucinous carcinoma and endometrioid carcinoma were 77.14%,50.00% and 66.67%,respectively,with no significant difference (P>0.05).The levels of these proteins in well-middle differentiated carcinoma and low differentiated carcinoma were 73.33% and 75.00%,respectively,with no significant difference (P>0.05).The levels of these proteins in Ⅰ-Ⅱ stage carcinoma,and Ⅲ-Ⅳ stage carcinoma were 18.18% and 93.75%,respectively,with significant difference (P<0.05).The levels ofmTOR protein in ovarian serous carcinoma,mucinous carcinoma and endometrioid carcinoma were 77.14%,100.00% and 83.33%,respectively,with no significant difference (P>0.05).The levels of this protein in well-middle differentiated carcinoma and low differentiated carcinoma were 80.00% and 78.57%,respectively,with no significant difference (P>0.05).The levels of this protein in Ⅰ-Ⅱ stage carcinoma,and Ⅲ-Ⅳ stage carcinoma were 27.27% and 96.88%,respectively,with significant difference (P<0.05).The levels of p70S6K protein in ovarian serous carcinoma,mucinous carcinoma and endometrioid carcinoma were 80.00%,100.00% and 100.00%,respectively,with no significant difference (P>0.05).The levels of this protein in well-middle differentiated carcinoma and low differentiated carcinoma were 93.33% and 78.57%,respectively,with no significant difference (P>0.05).The levels of this protein in Ⅰ-Ⅱ stage carcinoma,and Ⅲ-Ⅳ stage carcinoma were 45.45% and 96.88%,respectively,with significant difference (P<0.05).The levels of p-Akt protein in tissue of chemoresistance and chemosensitivity of ovarian cancer were 88.89% and 64.00%,respectively,with significant difference (P<0.05).The levels of mTOR protein in tissue of chemoresistance and chemosensitivity of ovarian cancer were 94.44% and 68.00%,respectively,with significant difference (P<0.05).The levels of p70S6K protein in tissue of chemoresistance and chemosensitivity of ovarian cancer were 100.00% and 72.00%,respectively,with significant difference (P<0.05).Conclusion:The p-Akt-mTOR-p70S6K signaling pathway may take part in invasion and metastasis of ovarian cancer.The up-regulation of these proteins may be associated with the chemoresistance of ovarian cancer,and these proteins may have potential to be the prognostic markers for the chemoresistance of ovarian cancer.

Objective:To collect the clinical materials of primary liver cancer patients treated by gamma knife and analyze the treatment methods as well as short-term efficacy,and to provide a reference for the clinical treatment of primary liver cancer patients.Methods:A total of 633 patients with inoperable primary liver cancer were treated by body gamma knife.According to the TNM staging method of Union for International Cancer Control(UICC), there were 351 cases with clear TNM staging.Among them, there were 251 cases (71.5%) at T3 stage and 57 cases(16.2%) at T4 stage.The prescription dose of 200-600 cGy each time to the 40%-85% dose line covering the planned target volume(PTV), this program was performed 5 times per week, and the number of treatment ranged from 2 to 13.The biochemical and imaging changes were observed 2-3 months after treatment to evaluate the short-term efficacy.Results:During the treatment, 229(36.2%)patients had adverse reactions,100 (15.8%) patients appeared the reduced white blood cells, and 137 (21.6%) patients appeared the reduced platelets.On discharge from the hospital, 601 patients were improved, 22 patients had no obvious change, 5 cases were worse, and 5 cases died.The proportion of improved patients who received the cumulative dose between 3 000 cGy to 4 000 cGy was higher than those who received the cumulative dose less than 3 000 cGy(P<0.05).After treatment, the curative effects were evaluated in 45 patients during two and three months, including PR 77.8%(35/45) and SD 22.2%(10/45), and the total effective rate was 77.8%(35/45).No statistical differences in effective rates were found between different tumor diameter, single dose, and cumulative dose groups(P>0.05).Conclusion:The proportion of adverse reactions in the primary liver cancer patients treated with body gamma knife is relatively low and the short-term efficacy is ideal.Body gamma knife treatment is a safe and effective treatment method for the primary liver cancer patients.

Objective We tried to explore the puerperal women's nature demand for management of health quotient,so as to provide theoretical basis for the health quotient management mode of puerperal women.Methods The phenomenological methodology was used in the research.Data of fifteen puerperal women were collected by semi-structured interview and analyzed by Colaizzi method.Results Four themes were summarized:health consciousness,health needs,in-hospital education status,social support needs.Conclusions The health quotient management of puerperal women is feasible.Therefore,the health quotient management model of maternal dominance and medical staff,family,peer support will be one of the maternal and infant health care research.

Objective To explore the role of cell apoptosis pathway in alcoholic pancreatitis.Methods C57BL/J mice were divided into control group (NC) and Alcohol group (AC),Acute pancreatitis group (AP) and Alcoholic acute pancreatitis group(AAP).Alcohol treatment was 10％ w/v ethanol feeding for 2 d,15％ w/v ethanol for 5 d,and then 20％ w/v ethanol until 13 weeks.AP model was established by the intraperitoneal injection of 50μg caerulein/kg body weight once an hour for a total of 7 times.Blood samples were collected for detecting serum amylase and lipase activity.Part pancreatic tissue was collected and the wet and dry weight were both measured to calculate the water content.The routine pathological exanination of the pancreatic tissues were conducted.The expression of apoptosis associated protein caspase3 and caspase8 was determined by Western blot.And cell apoptosis was determined using TUNNEL method.Results The level of serum amylase in NC group,AC group,AP group and AAP group were(3 630 ± 259),(3 196 ± 187),(35 955 ± 4607) and (53 607 ± 3 848) U/L;the level of serum lipase were (502 ± 41),(745 ± 42),(7 346 ± 665) and(12 764 ± 2 544) U/L;the water content were (70.2 ± 3.1) ％,(69.6 ± 2.0) ％,(78.2 ± 1.5) ％ and(85.0 ± 3.0) ％ and (12.75 ± 0.25);the expression of caspase3 were (1.017 ± 0.0784),(1.287 ± 0.097),(178 ± 0.07785) and (0.2443 ± 0.0243);the expression of caspase8 were (0.8289 ± 0.0096),(0.5985 ±0.0735),(1.27 ±0.08) and (0.145 ±0.015);the number of apoptotic cells were 1,6,214,97/10 high power field.The pathological score of pancreas injure in NC group,AC group,AP group and AAP group were 0,0,(7 ± 0.4) and (12.8 ± 0.3),respectively.Serum anylase,lipase,water content and pathological scores in AP group were obviously higher than those in NC group (P ＜ 0.05),which in AAP group were also obviously higher than those in AP group,and all the differences were statistically significant (all P ＜0.05).Compared with NC group,the expressions of apoptosis associated protein caspase3 and caspase8 and the number of apoptotic cells were obviously increased in AP group,which were obviously higher than those in AAP group,but the expression of caspase3 and caspase8 in AAP group were decreased compared with NC group,and all the differences were statistically significant (all P ＜ 0.05).Conclusions Chronic alcohol exposure may aggravate the severity of pancreatitis,and the inhibition of apoptosis pathway and the enhancement of acinar cell necrosis may be involved in this process.

Objective:To explore the scope, mode, anticoagulation mode and complications of blood purification in children with acute and critical illness.Methods:A total of 377 times of treatment of 102 children treated with blood purification in PICU at the First Affiliated Hospital of Xinxiang Medical College from January 2018 to December 2020 were retrospectively analyzed.Results:Among 102 critically ill children treated with blood purification, acute and chronic renal failure ranked the first in terms of disease distribution, with 23 cases in total, followed by 16 cases of severe viral encephalitis (meningoencephalitis), 11 cases of septic shock, seven cases of acute poisoning, five cases of severe allergic purpura, five cases of necrotic encephalopathy.In terms of clinical prognosis, 51(50.0%) cases were cured, 29(28.4%) cases were improved, 10(9.8%) cases died, and 12 cases abandoned treatment.In 2019, the blood purification application frequency was the highest, with a total of 47 cases, which was higher than those in 2018 and 2020( P<0.05). Continuous veno-venous hemofiltration was used in the largest number of children, with a total of 56 cases.There was a statistically significant difference in the application ratio of this mode during 3 years ( P<0.05), while there was no statistically significant difference in the application ratio of other modes.In terms of the selection of anticoagulation methods, the proportions of systemic anticoagulation and extracorporeal anticoagulation had significantly difference among different years( P<0.05), and the application of extracorporeal anticoagulation had increased year by year.There was no statistically significant difference in the proportion of patients without anticoagulants.The incidence of complications of blood purification was the highest in 2019, with catheter related thrombus in the majority (30 person-times), followed by hypothermia, catheter filter coagulation, hematoma formation, catheter related infection, hypotension, heparin-induced thrombocytopenia, etc.There was statistically significant difference in the total complications among different years( P<0.05). Conclusion:Blood purification is widely used in children with acute and critical illness, with a variety of diseases.The most commonly used mode is continuous veno-venous hemofiltration and in vitro anticoagulation.Catheter-related thrombosis is the most common complication.

Objective:To evaluate of the general practice residency training bases in Hebei Province.Methods:Based on the 2020 Standardized Residency Training Base Evaluation Index-General Practitioners of Chinese Medical Doctor Association,24 training bases in Hebei Province were assessed;and the satisfaction questionnaire survey and in-depth interview were conducted among 124 general practice trainees who were randomly selected in November 2020. Results:All 24 bases set the general practice department in the hospitals as required. However, the annual outpatient visits in department of general practice were less than 20000 in 45.83% (11/24) bases, only 41.67% (10/24) bases met the teaching requirements of general practice, and 33.33% (8/24) bases fulfilled the provincial target for general practice residency training enrollment; only 3 bases (13.64%) had the pass rate≥85% in medical licensing examination in the previous year. For the training satisfaction, 66.94% (83/124) trainees were satisfied with residency training, and 33.06% (41/124) were moderately satisfied. There was significantly difference in the satisfaction degrees among trainees with different expectations of career prospects (χ 2=24.436, P<0.05). Conclusions:Basically, the management system of general practice residency training bases has been completed and the construction of teaching teams has been standardized in Hebei Province. But the job attraction of general practitioner is inadequate, the training bases need to be strengthened, and the training quality needs to be improved.

Objective:To analyze the current status of faculty development in general practice residency training bases in Hebei Province.Methods:A questionnaire survey with deep interview was conducted among 79 faculty from 24 general practice residency training bases in Hebei Province during November to December 2020.Results:Among 79 participants, 21 were males (26.58%) and 58 were females (73.42%), 41 (51.90%) of whom were aged 31-40 years; 44 (55.70%) were general practitioners, and 35 (44.30%) were specialists. There were no significant differences in sex, age, education background, professional title, between faculty with general practice background and specialist background (all P>0.05); while there were significant differences in job-transfer training, teaching training for general practice, the training form, teaching method grasped, understanding the work contents of general practice, the view and prospect for general practice between general practitioner faculty and specialist faculty (all P<0.05). The score of ward round teaching of general practice faculty was significantly higher than that of specialist faculty ( P<0.05) The interview showed that all faculty members were willing to teach, most of them had increased work pressure after engagement in teaching, and there was lack of incentive policies for teaching in some bases. Conclusions:The current status of faculty development in the general practice residency training base in Hebei Province is basically satisfactory, but there is lack of general practice training for faculty with specialist background; the professional identity of general practitioner need to be enhanced, and their status and treatment need to be improved.